Making JSNA’s work for local communities and commissioners

Greater Manchester NHS Values Summit Group:

Ruth Passman Tony McDermottTracy Grey

Dr Matt Kearney National Clinical Advisor, Equality and Health Inequalities, NHS England / co-chair of Commissioning Assembly Health Inequalities group

• Making JSNA’s work for local communities and commissioners

• The role of Joint strategic need assessments and how they can help address local health inequalities and equality issues

• The Rapid review of JSNA’s through an equality and health inequalities lens- process and findings

• Can the Rapid Review approach be used to help JSNA’s work better for local communities and commissioners?

• Next Steps

Background

The Greater Manchester NHS Values Summit group convened following our Greater Manchester NHS Values Summit where leaders from the Area Team recognised the opportunity for joint work with local communities to establish a lasting post-event legacy. Volunteers with ‘lived experience’, community members, patients and third sector organisations are working together with health professionals to improve the delivery of integrated healthcare across Greater Manchester. Together, the group agreed to look at the role of Joint Strategic Needs Assessments (JSNA’s) in tackling health inequalities.

Joint Strategic Needs Assessment

• Mandatory requirement for HWBs - Health and Social Care Act 2012• Local authorities & CCGs equal and joint duties to prepare JSNAs• JSNAs are unique to each area – no standard template• Purpose

• To identify current & future health and wellbeing needs in light of existing services

• To inform future service planning• To identify priority areas for inclusion in Joint Health and Wellbeing

Strategy• To take into account evidence of effectiveness

JSNA – “a continuous process of strategic assessment and planning”

To identify local evidence-based priorities for commissioning by considering:• The demographics of the area• Needs of people of all ages of the life course • How needs may be harder to meet for the disadvantaged and

vulnerable wider social, environmental & economic factors that impact on wellbeing

• What health and social care information the local community needs• Local assets that can help to improve outcomes

Data and Intelligence

DH guidance: “A range of evidence should be used in JSNAs”:

1. Quantitative data – range of standard data sources and tools

2. Qualitative information• Views collected by the local Healthwatch organisation or

VSOs• Feedback given to local providers by service users• Community participation within the JSNA and JHWS process

3. More granular local needs assessments• District or ward level• Specific population groups• Wider determinants• Evidence of service outcomes

Inclusive HealthGuide to Commissioning Inclusive Services  

Does the JSNA:• Describe the scale of health inequalities in the area? • Identify the causes?• Capture and present health inequalities in a way that is

understandable and informs the JHWS?• Identify the most vulnerable and excluded, including Gypsies,

Travellers and Roma, the homeless, sex workers and vulnerable migrants?

• Reflect the knowledge and understanding of local voluntary and community groups?

Inclusive HealthGuide to Commissioning Inclusive Services  

Does the Joint Health & Wellbeing Strategy:

• Respond to the findings of the JSNA?• Build on what has been done and what has worked?• Tackle the problems with evidence-based action to an appropriate

scale?• Identify increased investment towards disadvantaged communities

and vulnerable groups?

Greater Manchester NHS Values Summit Group JSNA Rapid Review

Selection processQuick ChecklistRapid Review approachAnalysis

Pag

e1

Name of Health & Wellbeing Board / area

Is evidence provided in the Joint Strategic Needs Assessment (JSNA)

(yes/no)

Which Groups are mentioned in the JH&WB Strategy

(yes/no)

Are these groups mentioned in the Action Plan

(yes/no)

Do the documents meet the health needs of the population it serves? Does the evidence provided translate into action? Is this a good example of a JSNA and follow-up Strategy for action and briefly why?

Homeless people

Refugees and Asylum Seekers

New migrants

Drug and Alcohol dependents

People with Learning disabilities

Transgender people

What we found out

JSNA Rapid Review Findings

Level of reflection of community assets

Level of inclusion of the needs of those with protected characteristics and disadvantaged groups . Level of read across to health and wellbeing strategies and commissioning intentions

What practical steps can commissioners take, working with local communities, to identify and meet needs via the JSNA process and how can they ensure that identified needs are included in commissioning?

Using co-production and community-professional Rapid Review to influence and support the mainstream approach to JSNAs

Making JSNA’s work for local communities and commissioners. Next Steps?